Blood reserves and availability of blood preparations in University Clinical Center Tuzla, Bosni and Herzegovina

Abstract

INTRODUCTIONTransfusiontreatmentinmodernclinicalpracticeincludessubstitutiontherapy certaincomponentsoftheblood,whichadequatelyandeffectivelycontributetoquickrecoveryandhealing diseases[1].Almosteverybranchofmedicineistransfusion-dependent,startingwithsurgeryandinternalmedicine branchtodiagnosticones,wherethesafetyofthepatientisensuredbysubstitutionwithcertainblood preparations[2]. Bloodandbloodproductsdifferfromotherdrugsandpharmaceuticalpreparationswhile the only source is humanbloodfromvoluntarydonors[3].Inpractice theyusetwowaysofgettingblood,byvoluntarydonation,whenwholebloodistaken,whichisthemostcommon usedasastartingpointfortheproductionofotherdrugsfromblood,andbytheapheresisprocedureon cellseparator,whenonlyonebloodcomponentistaken,suchasplatelets,plasma, erythrocytes[1,4] Anadequatebloodtransfusionsupplyiscrucialforthefunctioningofthehealthsystem[5].Althoughtheyare bloodanditscomponentsrecentlyaddedtotheWHOessentialdruglist,insufficientbloodsuppliesinmost oflow-andmiddle-incomecountriesstillleadtomortalityandmorbidity,whichcan preventbyensuringsufficientbloodreserves[6,7]. Ensuringsufficientamountsofbloodimpliesstrategicconsiderationoflocal,epidemiological factors,demographicstructure,equipmentandabilitytoproducemedicinesfromwholeblood[8,9]. Currently,voluntaryblooddonationinmanylow-andmiddle-incomecountriesisnot adequately[10].Themainreasonsfortheunavailabilityofbloodisthehighprevalenceofviralhepatitisand inadequateproductionofbloodcomponents[11].Overallrelationsinsociety,socio-economicand demographicsareanimportantfactorforassessingthepossibilitiesofensuringstablereservesofsafeblood,which theyrepresentthenationalresourceofacountry[12].Theestimationofthedailyconsumptionofbloodproductsis unpredictablenature,duetopossibleincidentsituations,naturaldisasters,andlimited lifetimeofdifferentpreparations.Thelimitedlifespanofbloodincreasesthenumberofunuseddoses, resultinginadecreaseinstablereservesandhighcosts[6]. AccordingtoWHOguidelines,recommendationsforensuringstablebloodreservesinclude10to20 donationsper1000inhabitants[13].Theseassessmentsareimportantbecausetheycanservetoguidefurtherones investmentsinstrategiestoensuresufficientamountsofblood,thenanalysisofcurrenttransfusionpractice, introductionofrationalizationmeasuresduringtransfusiontreatmentandimplementationofthesystemfor bloodmanagement[14,15].IntheareaofTuzlaCanton,theannualblooddonationisapprox. 13000doses.Formorethanthreedecades,thePolyclinicforTransfusionhasbeenproducingvariousmedicinesfrom blood,whoselifespanandstoragemethodaredifferent,namely:wholeblood,erythrocyteconcentrate,concentrateerythrocyteswithareducednumberofleukocytes,irradiatederythrocyteconcentrate,freshfrozenplasma, plateletconcentrate,plateletconcentratewithreducednumberofleukocytes,irradiatedconcentrate platelets,plateletapheresisconcentrateandcryoprecipitate. MATERIALANDMETHODSThis retrospective study was carried out at the Polyclinic for Transfusion, University Clinical Center Tuzla data from the Renovatio information system in the period from July 1, 2022 to December 31, 2022. Data were analyzed on voluntary blood donors (age and gender), who donated blood during that period. Then data on the number of blood doses collected, as well as the number and type of medicines produced from blood (whole blood, erythrocyte concentrate, erythrocyte concentrate with reduced number of leukocytes, irradiated concentrate platelets, fresh frozen plasma, cryoprecipitate, platelet concentrate, platelet concentrate with a reduced number of leukocytes, irradiated platelet concentrate, irradiated platelet concentrate with reduced number of leukocytes, as well as platelet concentrate produced by the apheresis method using of the Amicus cell separator. Also, data was collected for patients who received blood preparations: age, gender, diagnosis, type of blood preparation indicated, name of the clinic where the patients were hospitalized, and the type and quantity of blood products issued. RESULTSThelargestnumberofdonatedbloodunitswasusedinthepreparationoffreshfrozenplasma,5742units,then5498unitsofplateletconcentrate,797unitsofcryoprecipitate,and308unitsofconcentrate plateletswithareducednumberofleukocytes,200unitsofirradiatedplateletconcentrateand119units irradiatedplateletconcentratewithareducednumberofleukocytes (Figure 1).